Comparing Two Federal Financing Strategies on Treatment Penetration and Sustainment

比较两种治疗渗透和维持的联邦融资策略

• 批准号: 10615202
• 负责人: Alex Richard Dopp
• 金额: $ 61.61万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10615202
• 关键词: Address; Administrator; Adolescent; Adoption; Award; Case Study; Certification; Client; Cohort Effect; Communities; Consultations; Data; Development; Elements; Eligibility Determination; Evidence based practice; Experimental Designs; Exploration, Preparation, Implementation, and Sustainment; Focus Groups; Funding; Grant; Health; Health Services; Infrastructure; Interview; Investments; Knowledge; Leadership; Measures; Mediating; Mediation; Mediator; Methods; Modeling; National Institute of Drug Abuse; Natural experiment; Outcome; Penetration; Perception; Policy Maker; Politics; Psychological reinforcement; Public Health; Public Policy; Quasi-experiment; Research; Research Design; Resources; Sampling; Secure; Substance Abuse Treatment Centers; Substance Use Disorder; Supervision; Surveys; System; Time; Training; United States National Institutes of Health; United States Substance Abuse and Mental Health Services Administration; Variant; Work; adolescent substance use; behavioral health; community based treatment; comparative; contextual factors; cost; data integration; health economics; implementation outcomes; implementation science; implementation strategy; innovation; novel; policy implication; statistics; substance use treatment; success; treatment organization; treatment services

PROJECT SUMMARY/ABSTRACT Sustained, widespread availability of evidence-based practices (EBPs) is essential to addressing the public health and societal impacts of adolescent substance use disorders (SUD), as recognized by the NIDA priority (Strategic Objective 3.4) to investigate strategies for effective and sustainable implementation of EBPs. There remains a particularly significant need to identify effective financing strategies, which secure and direct financial resources to support essential activities for EBP implementation and sustainment, and overcome cost-related barriers to the availability of effective adolescent SUD treatments. The proposed R01 project will compare the effects of two SAMHSA grant mechanisms (i.e., financing strategies), which supported the adoption of an EBP for adolescent SUD, the Adolescent Community Reinforcement Approach, through either organization-focused or state-focused granting of funds. The Exploration-Preparation-Implementation- Sustainment framework will guide our study aims, hypotheses, and selection of measures. The interdisciplinary project team – consisting of experts in implementation science, adolescent SUD treatment, health economics, public policy, and statistics – will employ a longitudinal, mixed method (i.e., quantitative surveys and qualitative interviews, document review, and focus groups), quasi-experimental design to compare the grant types’ outcomes and examine theoretically-informed mediators and moderators. Aim 1 will examine penetration of the Adolescent Community Reinforcement Approach among eligible clinicians (i.e., proportion certified with adequate fidelity) and clients (i.e., proportion receiving the treatment) at the end of SAMHSA funding; and Aim 2 will examine sustainment of the treatment model, using a 10-element composite measure of treatment delivery and supervision activities, up to 5 years post-funding. Our approach aligns with a previous grant (R01AA021217), enabling integration of the data we collect from state-focused grant recipients (85 organizations in 19 states) with previously collected data on implementation and sustainment outcomes among organization-focused grant recipients (84 organizations in 26 states). We will also evaluate non-equivalent dependent variables (i.e., outcomes that are not expected to change as a result of grant type) to control for key observable, time-varying cohort effects within our quasi-experimental study design. Finally, Aim 3 will use comparative case study methods to identify policy implications for promoting EBP penetration and sustainability through integration of our diverse quantitative and qualitative measures. The proposed research will have immediate, practical implications for behavioral health administrators, policymakers, implementation experts, and the public with new knowledge that can directly inform financing strategies to support large-scale, sustained EBP delivery in behavioral health – while simultaneously advancing the emergent implementation science field through use of novel methods to study financing strategies and sustainment outcomes.

项目概要/摘要 持续、广泛地提供循证实践 (EBP) 对于解决公众问题至关重要 NIDA 优先事项认可的青少年物质使用障碍 (SUD) 的健康和社会影响 （战略目标 3.4）研究有效和可持续实施 EBP 的策略。 仍然特别需要确定有效的融资战略，确保并指导 财政资源支持 EBP 实施和维持的基本活动，并克服 拟议的 R01 项目将阻碍获得有效的青少年 SUD 治疗的成本相关障碍。 比较两种 SAMHSA 拨款机制（即融资策略）的效果，这两种机制支持 采用青少年 SUD 的 EBP（青少年社区强化方法），通过 以组织为中心或以国家为中心的资金拨款。 维持框架将指导我们的研究目标、假设和措施的选择。 项目团队——由实施科学、青少年 SUD 治疗、卫生经济学、 公共政策和统计——将采用纵向混合方法（即定量调查和定性调查） 访谈、文件审查和焦点小组），用于比较资助类型的准实验设计 结果和理论上知情的调解员和调解员将检查渗透率。 合格选民中的青少年社区强化方法（即获得认证的比例） SAMHSA 资金和目标结束时的足够忠诚度）和客户（即接受治疗的比例）； 2 将使用 10 项综合治疗措施来检查治疗模型的维持情况 资助后 5 年内的交付和监督活动 我们的方法与之前的资助一致。 (R01AA021217)，能够整合我们从国家重点资助对象那里收集的数据 (85 19 个州的组织）之前收集了有关实施和维持结果的数据 我们还将评估以组织为中心的赠款接受者（26 个州的 84 个组织）。 因变量（即预计不会因资助类型而改变的结果）来控制关键 最后，目标 3 将使用我们的准实验研究设计中可观察到的、随时间变化的队列效应。 比较案例研究方法，以确定促进 EBP 普及的政策影响 通过整合我们多样化的定量和定性措施来实现可持续发展。 将对行为健康管理者、决策者、实施产生直接、实际的影响 专家和公众拥有新知识，可以直接为支持大规模、 在行为健康方面持续提供 EBP——同时推进紧急实施 科学领域通过使用新颖的方法来研究融资策略和可持续性成果。

项目成果

Comparing two federal financing strategies on penetration and sustainment of the adolescent community reinforcement approach for substance use disorders: protocol for a mixed-method study.

比较关于药物使用障碍青少年社区强化方法的渗透和维持的两种联邦融资策略：混合方法研究方案。

• 发表时间: 2022-05-13
• 作者: Dopp, Alex R;Hunter, Sarah B;Godley, Mark D;Pham, Chau;Han, Bing;Smart, Rosanna;Cantor, Jonathan;Kilmer, Beau;Hindmarch, Grace;González, Isabelle;Passetti, Lora L;Wright, Kelli L;Aarons, Gregory A;Purtle, Jonathan
• 通讯作者: Purtle, Jonathan

Perspectives on Financing Strategies for Evidence-Based Treatment Implementation in Youth Mental Health Systems.

对青少年心理健康系统循证治疗实施融资策略的看法。

• 发表时间: 2023-09-01
• 作者: North, Maddison N;Dopp, Alex R;Silovsky, Jane F;Gilbert, Marylou;Ringel, Jeanne S
• 通讯作者: Ringel, Jeanne S